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Comparative Evaluation of Magnetic Resonance-Guided Focused Ultrasound Surgery for Essential Tremor

Authors
 Kim M.  ;  Jung N.Y.  ;  Park C.K.  ;  Chang W.S.  ;  Jung H.H.  ;  Chang J.W 
Citation
 Stereotactic and Functional Neurosurgery, Vol.95(4) : 279-286, 2017 
Journal Title
 Stereotactic and Functional Neurosurgery 
ISSN
 1011-6125 
Issue Date
2017
Keywords
Deep brain stimulation ; Essential tremor ; Functional neurosurgery ; Magnetic resonance-guided focused ultrasound ; Stereotactic thalamotomy
Abstract
BACKGROUND: Treatment options for patients with drug-resistant essential tremor (ET) are limited. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is an emerging technique to treat refractory ET. OBJECTIVES: To present MRgFUS as an alternative to radiofrequency (RF) thalamotomy or deep brain stimulation (DBS) for ET treatment. METHODS: We retrospectively analyzed 59 patients who underwent unilateral surgery for drug-resistant ET. Treatments included RF thalamotomy (n = 17), DBS (n = 19), and MRgFUS (n = 23). The outcomes measured were tremor severity and treatment-related complications. RESULTS: At 1 month postoperatively, 100% of RF thalamotomy patients, 89.5% of DBS patients, and 91.3% of MRgFUS patients exhibited absent/mild tremor (successful treatment); other patients exhibited partial relief. At 12 months postoperatively, treatment success for each procedure was observed in 70.6, 84.2, and 78.3% of patients, respectively. At 1 month postoperatively, treatment-related complications had occurred in 58.8, 5.3, and 13.0% of patients, respectively. At 12 months postoperatively, side effects persisted in 11.8, 21.1, and 4.4% of patients, respectively. No statistical differences in treatment success were observed between treatments or over time. Complication rates differed between treatment modalities (p < 0.01) and were lowest in the MRgFUS group. CONCLUSIONS: Patients with drug-resistant ET received equivalent results from RF thalamotomy, DBS, and MRgFUS. DBS and MRgFUS resulted in fewer treatment-related complications.
Full Text
https://www.karger.com/Article/FullText/478866
DOI
10.1159/000478866
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Minsoo(김민수)
Park, Chang Kyu(박창규)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Na Young(정나영)
Jung, Hyun Ho(정현호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161731
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